Utility of Contact Investigation of Drug Susceptible and Resistant TB in Tanzani

这是为Elizabeth Fair博士申请的KOI奖，她是加州大学旧金山分校肺病和重症医学系的流行病学家。Fair博士正在成为流行病学和成本效益分析方面的研究人员，以评估在结核病和艾滋病毒高发病率和耐药结核病威胁日益增加的资源有限的环境中，新的结核病病例检测方法的可行性、成本和影响。该KOI奖将为Fair博士提供必要的支持，以实现以下目标：(1)成为应用先进分析方法评估规划结核病干预措施成本效益的专家；(2)学习应用传染病传播的数学模型来评估结核病干预措施的影响；(3)在低资源环境下成为前瞻性队列研究的设计、招募和管理专家；(4)应用结核病基因分型和耐药性检测的实验室研究技术；(5)发展独立的临床研究事业。实现这些目标。费尔博士组建了一个由主要导师组成的指导团队。国际公认的全球结核病控制权威Philip Hopewell博士和两位共同导师：国际公认的成本效益研究专家James G. Kahn博士。以及发表过大量文章的数学建模师和流行病学家Travis Porco博士指出，结核病新发病例较少是全球控制该疾病的主要限制，特别是在艾滋病毒高流行地区。Fair博士的研究将确定在低收入、高结核病负担环境下的家庭接触调查是否有助于结核病的早期诊断（目标1）。她还将评估项目条件下联系人调查的成本、成本效益和影响（目标2）；并确定通过家庭接触调查发现的新病例中结核分枝杆菌菌株的传播性和致病性（目标3）。这项研究将成为未来R01基金申请的基础，以解决结核病传播和致病性的科学基础，特别是耐药结核分枝杆菌菌株。

This is an application for a KOI, award for Dr. Elizabeth Fair, an epidemiologist in the Division of Pulmonary and Critical Care Medicine at the University of California, San Francisco. Dr. Fair is establishing herself as an investigator in epidemiologic and cost effectiveness analyses to evaluate the feasibility, cost, and impact of new tuberculosis (TB) case detection methods in resource limited-settings with high incidences of TB and HIV and increasing threats of drug-resistant TB. This KOI award will provide Dr. Fair with the support necessary to accomplish the following goals: (1) to become expert in applying advanced analytic methods for evaluating the cost effectiveness of programmatic TB interventions; (2) to learn to apply mathematical modeling of infectious disease transmission for evaluating the impact of TB interventions; (3) to become expert in the design, enrollment, and management of a prospective cohort study in a low resource setting; (4) to apply laboratory research techniques for TB genotyping and drug resistance testing; and (5) to develop and independent clinical research career. To achieve these goals. Dr. Fair has assembled a mentoring team comprised of a primary mentor. Dr. Philip Hopewell, an internationally recognized authority on global TB control, and 2 co-mentors: Dr. James G. Kahn, an internationally recognized expert on cost effectiveness studies, .and Dr. Travis Porco, a well-published mathematical modeler and epidemiologist, Low case finding of new TB patients is a major limitation to global control of the disease, especially in high HIV-prevalence areas. Dr. Fair's research will determine whether household contact investigation in a low-income, high TB burden setting results in earlier diagnosis of TB (Aim 1)..She will also assess the costs, cost-effectiveness, and impact of contact investigation under program conditions (Aim 2); and characterize the transmissibility and pathogenicity of M.tb strains from new cases found through household contact investigation (Aim 3). The research will form the basis for a future R01 grant application to address the scientific basis of TB transmission and pathogenicity, specifically of drug-resistant M.tb strains.